Synthetic Chemical Trade as a Potential Driver of Global Health Disparities and Data Gaps on Synthetic Chemicals in Vulnerable Populations.

PURPOSE OF REVIEW: Most research on toxic exposures in vulnerable populations focuses on air pollution. Synthetic chemical production, however, is a multi-billion-dollar industry that lacks appropriate international regulation to protect those exposed to toxic chemicals. This paper aims to describe the country-level import and export of key groups of synthetic chemicals using data from the United Nations Comtrade Database and provide a narrative review of the evidence from January 2018 to August 2019 on exposure to, health effects of, and interventions to reduce synthetic chemicals in vulnerable populations around the world. RECENT FINDINGS: Generally, a small number of high-income countries export the majority of synthetic chemicals, while most low-income countries import more chemicals than they export, which may contribute to higher levels of synthetic chemicals in those settings. However, few studies have quantified exposures to synthetic chemicals in low- and middle-income countries, the health effects of such exposures, or interventions to mitigate exposures. Synthetic chemicals continue to enter markets despite our limited knowledge of their effects on human health, particularly in the most vulnerable populations. We need more research to understand the health impacts of these pervasive exposures.

Prime eligible poisons: identification of extremely hazardous substances available on Amazon.com®.

Background: Widespread use of the Internet has increased availability of numerous products. Multiple published cases highlight that toxic xenobiotics are available for purchase online. Most cases describe purchase from the deep web. We sought to identify extremely hazardous substances available from an online retailer.Methods: Over a 10-month period, the online retailer Amazon.com® was searched for each of the products listed by the Environmental Protection Agency's "List of Extremely Hazardous Substances." Product names, availability on Amazon Prime®, need for a business account, price, and quantity were collated.Results: We identified 79/340 (23.2%) of these substances were available on Amazon.com®. Almost one-third of the available substances were eligible for Amazon Prime®. Approximately one-third of the products were available in an amount that could be toxic by purchasing a single unit (31/79). Of these 31 products, only four required a business account, 18 were eligible for Amazon Prime®, and nine were neither eligible for Prime nor required a business account. Notable products include sodium azide, acrylamide, mercuric acetate, and hydrazine.Conclusions: The ease of purchase and ready availability of such highly toxic substances is concerning. Online retailers like Amazon.com® should consult with toxicologists or other qualified experts and governmental agencies to identify which products should be removed or restricted to business accounts.

Impact of REACH legislation on the production and importation of CMR (carcinogen, mutagen and reproductive) and explosive chemicals in Italy from 2011 to 2015.

On 1 June 2007, the European Commission issued the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) to protect both the environment and human health. We analyzed the impact of REACH in the Italian market considering the presence of chemicals, their diversity, importation and production during the period 2011-2015, with particular attention to products with toxic or explosive properties. There was a reduction of the chemicals on the market, in terms of tons but also the absolute numbers of types of compounds. The production reduction was particularly noticeable for explosive chemicals: -14.7%. CMR products did not show any statistically significant reduction in term of tons: -2.3%.

Advancing safer alternatives through functional substitution.

To achieve the ultimate goal of sustainable chemicals management policy­the transition to safer chemicals, materials, products, and processes­current chemicals management approaches could benefit from a broader perspective. Starting with considerations of function, rather than characterizing and managing risks associated with a particular chemical, may provide a different, solutions-oriented lens to reduce risk associated with the uses of chemicals. It may also offer an efficient means, complementing existing tools, to reorient chemicals management approaches from time-intensive risk assessment and risk management based on single chemicals to comparative evaluation of the best options to fulfill a specific function. This article describes a functional approach to chemicals management we call "functional substitution" that encourages decision-makers to look beyond chemical by chemical substitution to find a range of alternatives to meet product performance. We define functional substitution, outline a rationale for greater use of this concept when considering risks posed by uses of chemicals, and provide examples of how functional approaches have been applied toward the identification of alternatives. We also discuss next steps for implementing functional substitution in chemical assessment and policy development.

Management of clandestine drug laboratories: need for evidence-based environmental health policies.

Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.

Require safer substitutes and solutions: making the substitution principle the cornerstone of sustainable chemical policies.

Currently, chemical regulations in the United States do not prioritize the production and use of inherently safe chemicals. At present, when regulations get passed to target a chemical for control, safer substitutes are not the goal nor are there specific guidelines or tools used to achieve Green Chemistry, Clean Production, or sustainable product design. In most cases, the replacement is often just as hazardous or simply a reduction of the quantity or concentration of the toxic substance that has been targeted. In contrast, by placing the Substitution Principle at the heart of new chemical policies and regulations, hazardous chemicals would be replaced with less hazardous alternatives or preferably alternatives for which no hazards can be identified. This would hasten the uptake of Green Chemistry, or environmentally benign chemical synthesis. Substituting hazardous chemicals goes beyond finding a drop-in chemical alternative and can include systems, materials or process changes. Regulatory drivers include a clear timeline for phase out of priority chemicals based on their inherent hazard, mandatory substitution planning for hazardous chemicals, financial and technical support for companies to find safer materials, and increased funding for green chemistry development and uptake by companies.

Phase out persistent, bioaccumulative or highly toxic chemicals.

Chemicals such as lindane, lead compounds, and some brominated flame retardants and organophosphate pesticides are examples of persistent, bio-accumulative, and/or highly toxic chemicals that continue to be used in commerce, although strong evidence exists that they pose threats to human and ecosystem health. These and other chemicals, by virtue of their characteristics, are very difficult to manage without unacceptable threats to workers, the environment, or ecosystems. Chemicals that cannot be safely managed should be prioritized for phase out. A transparent process to further identify and prioritize the list of chemicals for phase out is needed. With few exceptions, the U.S. government lacks the authority or an efficient policy instrument to prevent these high-priority chemicals from being used in products and processes or released to the environment. It also has been very difficult for state and local governments to restrict these chemicals. Policy instruments to efficiently and effectively phase out problematic chemicals are needed at all levels of government.

Assessing poisoning risks related to storage of household hazardous materials: using a focus group to improve a survey questionnaire.

BACKGROUND: In fall of 2004, the authors began an investigation to characterize the correlations between the storage of Household Hazardous Materials and the associated health risks, particularly to children. The study area selected was Genesee County, Michigan, near Flint, with data to be collected by a phone survey of residents and through the acquisition of county hospital records containing procedure codes indicating treatment for poison emergencies, and review of poison control center data. METHODS: A focus group was used to identify key topics and relationships within these data for improving the phone survey questionnaire and its analysis. RESULTS: The focus group was successful in identifying the key issues with respect to all the data collection objectives, resulting in a significantly shorter and more topically focused survey questionnaire. Execution time of the phone survey decreased from 30 to 12 minutes, and useful relationships between the data were revealed, e.g., the linkage between reading food labels and reading labels on containers containing potentially harmful substances. CONCLUSION: Focus groups and their preparatory planning can help reveal data interrelationships before larger surveys are undertaken. Even where time and budget constraints prevent the ability to conduct a series of focus groups, one successful focus group session can improve survey performance and reduce costs.

Clandestine drug laboratories in Australia and the potential for harm.

The emphasis in the literature regarding illicit drugs has been overwhelmingly on the subject of harm caused by their ingestion. Little has been reported on the potential and real harm associated with the illicit manufacture of drugs. This paper describes the increasing prevalence of clandestine drug laboratories in Australia, overwhelmingly devoted to the manufacture of methamphetamine. The nature of the illicit synthetic process is reviewed together with its inherent dangers for the 'cook', first responders and bystanders including children, and the environment. We have analysed the emerging trends in manufacture and seizure in Australia, and offer suggestions to remedy significant deficiencies in knowledge and policy in the management of clandestine drug laboratories, especially with reference to clinical management issues, data collection, environmental contaminants and remediation, legislation and research. In particular, we conclude that: The problem of clandestine drug laboratories is growing in Australia, reflecting patterns world-wide. There are significant health and environmental implications of this growth. First responders should ensure that specialised expertise is available when decommissioning detected laboratories. Clinicians should familiarise themselves with the types of injuries associated with clandestine drug manufacture. Legislatures without a clandestine drug laboratory registry should establish one. Where it doesn't exist, legislation should be sought to curb the spread of this unwanted phenomenon. Significant opportunities exist for further research into the harm caused to first responders, the community, and the environment by clandestine laboratories.

[Responsibilities of enterprises introducing new dangerous chemical substances and preparations]. / Obowiazki podmiotów gospodarczych wprowadzajacych do obrotu substancje lub preparaty niebezpieczne.

The paper reviews the responsibilities of producers, importers and distributors set in a new Act of January 2001 on chemical substances and preparations (Off. J. 2001, No. 11, item 84, with subsequent amendments). This Act together with executive provisions is aimed at harmonizing Polish legislation with EU requirements. The Act sets conditions, restriction and bans of production placing on the market and use of chemical substances and preparations in order to protect human health and environment against their harmful effects. The Act together with a number of executive provisions render those who introduce dangerous chemicals and chemical preparations, including distributors responsible for: classification and labelling of dangerous chemical substances and preparations; possessing, making available and up-dating safety data sheets; supplying packages containing certain dangerous substances with child-proof fastenings; notifying the Inspector for Chemical Substances and Preparations about placing a dangerous preparation on the market; notifying the Inspector about a new substance and conducting required studies; being properly qualified to handle dangerous substances. The Act strictly defines the term "placing a substance or a preparation on the market"--it means making a substance or a preparation available to third parties on the territory of The Republic of Poland, territories of the Member States of the European Union or the territory of Iceland, Liechtenstein and Norway, unless the Act provides otherwise; it also means introduction of a substance or a preparation from outside of the territory referred to above on the customs territory of The Republic of Poland, or that of the member states of the European Union and other states listed above. In addition, some of the responsibilities defined by the provisions of the law on chemical substances and preparations are also applicable to handling of biocidals, which are classified as dangerous substances. The Act also defines the terms "substance" and "chemical preparation" and sets the rules for classification and labelling of dangerous chemical substances and preparations (criteria for classification, rules for labelling, introduces the official classification and labelling of certain substances in the "list of dangerous substances"). The Act identifies methods to be used in the tests of physico-chemical properties, toxicity and ecotoxicity of chemical substances and preparations to meet the legal requirements and sets criteria to be followed by institutions involved in such testing.

The Frontlines of Medicine Project: a proposal for the standardized communication of emergency department data for public health uses including syndromic surveillance for biological and chemical terrorism.

The Frontlines of Medicine Project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. This collaboration proposes to develop a nonproprietary, "open systems" approach for reporting emergency department patient data. The common element is a standard approach to sending messages from individual EDs to regional oversight entities that could then analyze the data received. ED encounter data could be used for various public health initiatives, including syndromic surveillance for chemical and biological terrorism. The interlinking of these regional systems could also permit public health surveillance at a national level based on ED patient encounter data. Advancements in the Internet and Web-based technologies could allow the deployment of these standardized tools in a rapid time frame.